Proper patient monitoring and follow-up of retinal diseases used to require a highly specialized and expensive fundus camera. That is no longer the case with the new DIYretCAM, a smartphone adapter for fundus imaging created by Dr. Biju Raju and colleagues from the Department of Vitreoretinal Diseases, Vasan Eye Care Hospital in Association with Ranjini Eye Hospital, Kochi, India. Made using a smartphone and materials easily and cheaply available anywhere in the world, this new device is giving doctors and patients access to good quality images that will improve patient outcomes.
As the name suggests you can make this optical tube device yourself using simple PVC, sandpaper, Super Glue, cardboard and a few other materials. The cost is less than $1 (USD), and is designed to be easier to construct than your typical purchase from IKEA. According to Dr. Raju, most people can complete the build in around 30 minutes, plus he has a video available online to guide you on the step-by-step procedure.* Then just pop in a 20D lens, attach to your smartphone and you’re ready to go.
So what can the DIYretCAM image? You can see the central retina and the peripheral retina up to the pars plana. The device can be mounted on a slit lamp to give more control, providing better focus of the retina while imaging the disc and posterior pole. Additionally when using matched ﬁlters, ﬂuorescein angioscopy of the central and peripheral retina can be performed.
“Besides the routine ophthalmic imaging, the DIYretCAM becomes extremely useful in documenting the retinal changes in a bedridden patient or while screening neonates for retinopathy of prematurity (ROP), for which currently there are no cost-effective techniques,” explained Dr. Raju.
Once the images are obtained, Dr. Raju recommends using Adobe PhotoShop Express (a free tool) to edit the image for brightness and contrast. He even learned that central reﬂection can be removed using the app’s blemish removal tool. Also, with the PicsArt app (also a free tool), a montage of multiple fundus images can be created, keeping the entire process simple and able to be completed solely with a smartphone. No computer needed! Once the images are ready, they can be shared securely to professional peers easily using instant messaging apps like WhatsApp.
This portable, cost-friendly device is obviously most useful for ophthalmologists who don’t have access to a conventional fundus imaging system, particularly those who are serving the peripheral or rural centers. And because of the DIYretCAM’s simple construction and ability to be adapted to any smartphone, patients all around the world can beneﬁt from it. It is the epitome of teleophthalmology, allowing images to be shared quickly and easily from remote areas to retinal specialists.
That is precisely one the factors which motivated Dr. Raju to invent this device.
“I believe that teleophthalmology, in its true sense, should be a smartphone based imaging technology, because of the wide range of connectivity options that smartphones offer and because almost everyone has a good smartphone nowadays,” he said. More importantly, because Dr. Raju is a passionate advocate for better access to care for all, he has kept his design open source instead of going the commercial route so that it can equally reach everyone around the world.
With the DIYretCAM, patient monitoring and follow-up of retinal diseases are no longer reliant on an expensive and specialized fundus camera. Using just a smartphone and some other basic materials, you can have your own DIYretCAM in about 30 minutes for the amazing price of $1. DIYretCAMs for all are ﬁnally here!
Raju B, Raju NSD, Akkara JD, et al. Do it yourself smartphone fundus camera – DIYretCAM. Indian J Ophthalmol. 2016; 64(9): 663–667.